St. John'S Medical Group
Clinic/Center, Rural Health in Baxter Springs, KS. Organization (NPI-2).
NPI number1962438457
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1962438457
- Entity type
- Organization (NPI-2)
- Legal business name
- St. John'S Medical Group
- Organization subpart
- No
- Enumeration date
- Jun 25, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
Practice location
445 E 10th StBaxter Springs, KS 66713-1614
Phone 620-856-3469 · Fax 620-856-5330
Mailing address
2631 Cunningham AveSuite A
Joplin, MO 64804-1543
Phone 417-627-8967 · Fax 417-627-8951
Authorized official
Paul Ebmeier
Coo
4176278967
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